Patient Insurance Specialist

Patient Insurance Specialist at American Family Care serves as the initial point of contact for patients and visitors, ensuring a smooth and efficient front desk operation. This role is responsible for patient registration, insurance verification, medical record management, billing, and payment collection. The Medical Receptionist plays a vital role in maintaining the flow of administrative tasks while delivering exceptional customer service.

Essential Duties and Responsibilities

• Patient Check-in: Greet patients upon arrival, verify insurance information, ensure all web check-in procedures are followed
• Phone & Appointment Management: Answers phone calls to the clinic and provides information or refers questions to others as needed.
• Patient Registration: Accurately collect and update patient demographics, medical history, and insurance details.
• Insurance Verification: Verify patient insurance coverage. Confirm eligibility, deductibles, and co-pays through practice management system or direct provider communication. Resolve discrepancies prior to patients visit.
• Billing & Payments: Process patient payments, manage outstanding balances, and coordinate with insurance providers. Ensure accurate entry of charges, collect co-pays and outstanding balances at the time of service, and provide patients with payment plan options as needed.
• Medical Records Management: Maintain, file, and retrieve patient records while ensuring accuracy, confidentiality, and compliance with HIPAA regulations.
• Office Administration: Maintain reception area cleanliness, manage office supplies, and perform basic clerical duties.
• Cash Collection & Financial Reporting: Complete daily balance checklists, reconcile all forms of payment, and prepare end of day balance sheets. Ensure cash, check, and credit card payments are accurately recorded and securely stored. Prepare and drop deposits into the safe.
• Clinic Operations: Assist in opening and closing procedures, ensuring all systems are operational and ready for patients.
• Follow-Up Coordination: Assist patients with scheduling follow-up appointments and fulfilling medical documentation requests as needed.
• Other Duties: Perform additional administrative and operational tasks as assigned to ensure smooth clinic function.
• Regular attendance to ensure efficient clinic operations.
• Other duties and responsibilities as assigned.

Qualifications

Education & Experience:

• High school diploma or equivalent required.
• Associate degree or certification in Office/Medical Administration preferred.
• Minimum 3 years of experience in a medical office setting required.
• Strong understanding of health insurance processes is highly desirable.

Required Skills:

• Strong customer service and communication skills.
• Proficiency in Microsoft Office and electronic medical records (EMR) systems.
• Exceptional organizational and multitasking abilities.
• Attention to detail and ability to maintain confidentiality in compliance with HIPAA regulations.

Physical Demands/Work Environment

Office environment. Standing for extended periods of time. Sitting and keyboarding for

extended periods of time. Reaching and stooping for files. High attention to detail and ability to focus. Potential exposure to potentially infectious material and chemicals